Goyal Nishant, Agrawal Deepak, Singla Raghav, Kale Shashank Sharad, Singh Manmohan, Sharma Bhawani Shankar
Department of Neurosurgery and Gamma Knife, All India Institute of Medical Sciences, New Delhi, India.
J Neurosci Rural Pract. 2016 Jan-Mar;7(1):23-7. doi: 10.4103/0976-3147.172165.
Although gamma knife has been advocated for hemangioblastomas, it is not used widely by neurosurgeons.
We review our experience over 14 years in an attempt to define the role of stereotactic radiosurgery (SRS) in the management of hemangioblastomas.
A retrospective study was conducted on all patients of hemangioblastoma who underwent SRS at our institute over a period of 14 years (1998-2011). Gamma knife plans, clinical history, and radiology were reviewed for all patients.
A total of 2767 patients underwent gamma knife during the study period. Of these, 10 (0.36%) patients were treated for 24 hemangioblastomas. Eight patients (80%) had von Hippel-Lindau disease while two had sporadic hemangioblastomas. The median peripheral dose (50% isodose) delivered to the tumors was 29.9 Gy. Clinical and radiological follow-up data were available for eight patients. Of these, two were re-operated for persisting cerebellar symptoms. The remaining six patients were recurrence-free at a mean follow-up of 48 months (range 19-108 months). One patient had an increase in cyst volume along with a decrease in the size of the mural nodule.
SRS should be the first option for asymptomatic hemangioblastomas. Despite the obvious advantages, gamma knife is not widely used as an option for hemangioblastomas.
尽管伽玛刀已被推荐用于治疗血管母细胞瘤，但神经外科医生并未广泛使用。
我们回顾了14年的经验，试图确定立体定向放射外科（SRS）在血管母细胞瘤治疗中的作用。
对我院14年（1998 - 2011年）期间接受SRS治疗的所有血管母细胞瘤患者进行回顾性研究。对所有患者的伽玛刀治疗计划、临床病史和影像学资料进行了审查。
研究期间共有2767例患者接受了伽玛刀治疗。其中，10例（0.36%）患者因24个血管母细胞瘤接受治疗。8例（80%）患者患有冯·希佩尔 - 林道病，2例为散发性血管母细胞瘤。肿瘤接受的中位周边剂量（50%等剂量线）为29.9 Gy。8例患者有临床和影像学随访数据。其中，2例因小脑症状持续存在而再次手术。其余6例患者在平均48个月（范围19 - 108个月）的随访中无复发。1例患者囊肿体积增大，同时壁结节大小减小。
SRS应作为无症状血管母细胞瘤的首选治疗方法。尽管有明显优势，但伽玛刀并未被广泛用作血管母细胞瘤的治疗选择。
